The Lower Esophageal Sphincter Shown by a Computerized Representation

Abstract

The clinical application of manometry of the lower esophageal sphincter (LES) remains controversial. This is because of the large variability in recorded lower esophageal sphincter pressure (LESP). In this paper a computerized method providing a three-dimensional image of the LES is described. In 12 healthy subjects end-expiratory rapid pull-through LESP recordings were performed for 1 h, using a perfused 8-channel probe. A cylindric model of the sphincter was calculated by means of a graphics program. The graphic representation of the LES demonstrated a circular pressure zone that was affected by the gastric migrating motility complex. This pressure zone was located proximal to a persistent indentation in the posterior and right posterolateral direction. Three-dimensional visualization of the LES provides additional information that cannot be obtained by the usually used techniques of analysis of sphincter manometry.

Static single channel and multichannel water perfusion pressure profilometry in a bench model of a urethra

“…With this technique a perfusion catheter with several perfusion channels opening near the tip of the catheter is withdrawn through the sphincter and produces a series of individual pressure profiles, similar to urethral pressure profiles. As well as providing quantitative data of sphincteric pressure recorded in different directions, these data may then be converted into a three dimensional image of sphincteric pressure by a computer software program 25, 26…”

Comparison of lower oesophageal sphincter pressure measurement using circumferential vs unidirectional transducers

“…Three-dimensional sphincter profile using radially measured sphincter pressures and computerized axial manometry was first reported by Bombeck et al 10 They introduced the concept of`sphincter pressure vector volume' (SPVV) as a parameter which integrates sphincter pressures exerted along the entire length of the sphincter and the circumference into one value representing LOS resistance. Subsequently, Bemelman et al 11 and more recently Stein and his associates 12 have developed a three-dimensional imaging of the LOS as a means of quantifying LOS resistance in normal volunteers and in patients with gastro-oesophageal reflux disease. A calculated sphincter pressure vector volume (SPVV) less than 5th percentile of normal is an indication of a mechanically defective sphincter.…”

The effect of esophageal myotomy and myectomy on the lower esophageal sphincter pressure profile: intraoperative computerized manometry study

“…Computerized data acquisition was obtained connecting the amplifiers to an A/D converter mounted in a Compaq PC. Data were sampled at a rate of 100/s for each channel for 20 s. The quantitative and qualitative analysis (3D‐representation) was achieved with the original method previously described 7 …”